Influencing factors of pulmonary infection in elderly CHD patients with HF and construction of a risk prediction model for the infection
10.3969/j.issn.1009-0126.2024.11.006
- VernacularTitle:老年冠心病并发心力衰竭患者院内肺部感染影响因素及风险预测模型构建
- Author:
Lei FEI
1
;
Mingxin GAO
;
Shuhua WU
;
Yaqiong LU
Author Information
1. 215000 苏州大学附属第二医院老年科
- Keywords:
coronary disease;
heart failure;
proportional hazards models;
pneumonia;
forecasting
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2024;26(11):1277-1280
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the influencing factors of nosocomial pneumonia in elderly pa-tients with CHD and HF.Methods A total of 196 elderly CHD patients with HF diagnosed and treated in our department from March 2021 to August 2023 were enrolled,and divided into infec-ted group(n=52)and non-infected group(n=144)based on whether pulmonary infection oc-curred during hospitalization.Logistic regression analysis was used to identify the risk factors af-fecting secondary nosocomial pulmonary infection.Based on these risk factors,a comprehensive in-dex was built.ROC curve was drawn to analyze the diagnostic value of the index for secondary nosocomial pulmonary infection.Results The infected group had significantly advanced age,lar-ger proportions of NYHA grade Ⅲ to Ⅳ,smoking history,diabetes history,mechanical ventila-tion time＞48 h,length of hospital stay＞14 d,and albumin at admission＜30 g/L,and higher RDW at admission when compared with the non-infected group(P＜0.05,P＜0.01).Logistic regression analysis showed that NYHA grade Ⅲ to Ⅳ,diabetes history,mechanical ventilation time＞48 h,length of hospitalization＞14 d,albumin＜30 g/L at admission and RDW at admis-sion were risk factors for secondary nosocomial pulmonary infection in elderly CHD patients with HF(OR=2.398,95％CI:1.157-4.969;OR=2.732,95％CI:1.278-5.839;OR=2.607,95％CI:1.138-5.973;OR=3.368,95％CI:1.567-7.242;OR=2.677,95％CI:1.218-5.886;OR=1.762,95％CI:1.488-61.222).ROC curve analysis indicated that the AUC value of NYHA grade Ⅲ to Ⅳ,diabetes history,mechanical ventilation time＞48 h,length of hospitalization＞14 d,albumin＜30 g/L at admission and RDW at admission in predicting secondary nosocomial pulmonary infec-tion in elderly CHD patients with HF was 0.598,0.620,0.586,0.595,0.615 and 0.850,respectively,and the value of the comprehensive index was 0.743,which is superior to that of above single indi-cator(P＜0.05).Conclusion Age,NYHA grade,smoking history,diabetes history,mechanical ventilation time,hospital stay and albumin and RDW levels at admission have adverse effects on secondary nosocomial pulmonary infection in elderly CHD patients with HF.Our built compre-hensive index based on these risk factors has high efficacy in predicting nosocomial pulmonary in-fection.
